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PMT16-03843 City of Menifee Permit No.: PMT16-03843 29714 HAUN RD. Type: Pool/Spa-Residential <A—CCEILA—> MENIFEE,CA 92586 MENIFEE Date Issued: 11130/2016 P E R M I T Site Address: 30426 COWBOY LN, MENIFEE, CA 92584 Parcel Number: 358-522-021 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INGROUND POOL ONLY 307 SQ FT Work: Owner Contractor THELMA BARNETT PACIFIC COAST POOLS INCORPORATED 30426 COWBOY LN 26499 JEFFERSON AVE UNIT E MENIFEE,CA 92584 MURRIETA, CA 92562 Applicant Phone:9512960199 BRAND[ CORAL License Number.852237 PACIFIC COAST POOLS INCORPORATED 26499 JEFFERSON AVE UNIT E MURRIETA, CA 92562 Fee Description QtV Amount($1 Swimming PooUln-Ground Spa 1 467.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 23.35 $522.35 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing bulliding operations being carried on thereunder when In violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a pennit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA.Bldg_Penit_Ternplate.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or Improves thereon,and who contracts for the projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exempt from licensure under the Contractor's State License Law for Professions Code and I' e.s.nfullf -eandeffLct the following reason: License Class Lie No. P;2:2Z7- By my signature below I acknowledge that,except for my personal residence Expires_Signature in which I must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKEWS COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by o I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which wvM.leMnfo.ca.govJcaIaw.htmI. this permit Is issued. Policy If Date a I have and will maintain worker's compensation insurance,as required by PROPiATY OWNER OR'AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which ci By my signature below I certify to each of the following:I am the property this permit is Issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number am: application and the information I have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to ui construction.I authorize representatives of this city or county to Policy#\3 v--1 W 0:�'e)-O"Llpires ente bove identified property for inspection purposes. (ThIssection need notto becompleted isthepermitisforone-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation lam of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall fort5th comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ci Yes ci N6 UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY 0 Yes -ff—ho— I hereby affirm that under the penalty of perjury there Is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer bounda" of a school? (Section 3097 Civil Code) ri Yes :rl � OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and theSCAQMD permitting checklist.I understand my requirements undertheState of I hereby affirm under penalty of perjury that I am exemptfrom the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazardou�d. reporting. checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 oYes; a No Business and Professions Code).Any city or county that requires a permit to construct,alter,Improve,demolish or repair any structure,prior to its Date issuance,also requires the applicant for the permit to file a signed statement PROPERTY OVfNER OR AUTHORIZED AGENT that he or she Is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPJ License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from licensure receiving compensation for Most Work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certifled firms and comply with a n Applica nt for a permit subjects the applica nt to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their c 1,as owner of the property,or my employee with wages as their sole employees.For more Information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the Structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a ci An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement Is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: o 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION t"Men'fee DATE PERMIT/PLAN CHECK NUMBERFkvTk0- TYPE: 0 COMMERCIAL 0 RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME POOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION C)DEMOLITION OELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES_ _ DESCRIPTION OF WORK JIC��L� PROJEcTADDRESS ffQ/rv_V'(-CZ� ASSESSOR'S PARCEL NUMBER 069 6XUPI LOT 44 TRACT OWNERNAME A t )(-,L ADDRESS PHONE EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? 0 YES Ca4d' BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ SO FT LSQFT APPLICANT'S SIGNA DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION 1p CITY OF MENIFEE BU51NI;kS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN S INVOICE PAID AMOUNT AMOUNT 95PA:b5l I � OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES I PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Bufiding& Safety Department 29714 Haun Rd. Menifee, C4 92585 951-672-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213 PL VINYL FENCE 67ALL kLL, COPING SAME AS +12" GAI ;TONE FACE +12" RAISED BOND BEAM POOL, Sl STACKED STONE FACE A ACCES CCESfSBOBCAT 2-18" SHEER DESCENT WATERFALLS :PLAN:TER PLANTER PLANTER FER 7CONCRET� DECKING 6'DEPTH 4'DEPrH 316"DEP POOL 13 UMBRELLA HOLE EXISTING RESIDENCE N